Meyer J S, Rauch G, Rauch R A, Haque A
Cerebral Blood Flow Laboratory, Veterans Administration Medical Center, 77030, Houston, TX, USA.
Neurobiol Aging. 2000 Mar-Apr;21(2):161-9. doi: 10.1016/s0197-4580(00)00136-6.
Putative risk factors accelerating mild cognitive decline and dementia were correlated with repeated measures of cerebral atrophy, CT, densitometry, perfusions, and cognitive testing among neurologically and cognitively normative aging volunteers. A total of 224 normative subjects at increased risk for cognitive decline were admitted to the study. Mean entry age was 59.5 +/- 15.8 years. Mean follow-up is 5.8 +/- 3.3 years. At follow-up, 22 developed mild cognitive impairment (41 CCSE >/= -3), 19 became demented-8 with Vascular type (VAD), 11 with Alzheimer's type (DAT)-and 183 remain cognitively unchanged. Cerebral atrophy, tissue densities, and perfusions were measured by Xe-CT. After age 60, cerebral atrophy, ventricular enlargement, and polio- and leuko-araiosis geometrically increased as perfusions declined. Risk factors accelerating perfusional decline, cerebral atrophy, polio-araiosis, and leuko-araiosis were: transient ischemic attacks (TIAs), hypertension, smoking, hyperlipidemia, and male gender. At age 71.5 +/- 11.9, mild cognitive impairment began accelerated by TIAs, hypertension and heart disease. Leuko-araiosis began before cognitive decline. TIAs, hypertension, and hyperlipidemia correlated with VAD. Excessive cortical perfusional decrease, gray and white matter hypodensities, and cerebral atrophy correlate with cognitive decline.
在神经和认知功能正常的老年志愿者中，加速轻度认知衰退和痴呆的假定风险因素与脑萎缩、CT、骨密度测定、灌注以及认知测试的重复测量结果相关。共有224名认知衰退风险增加的正常受试者被纳入该研究。平均入组年龄为59.5±15.8岁。平均随访时间为5.8±3.3年。随访时，22人出现轻度认知障碍（41人CCSE≥-3），19人患痴呆症——8人患血管性痴呆（VAD），11人患阿尔茨海默病型痴呆（DAT）——183人认知状态未变。通过氙CT测量脑萎缩、组织密度和灌注。60岁以后，随着灌注下降，脑萎缩、脑室扩大以及脑软化和白质疏松呈几何级数增加。加速灌注下降、脑萎缩、脑软化和白质疏松的风险因素有：短暂性脑缺血发作（TIA）、高血压、吸烟、高脂血症和男性。在71.5±11.9岁时，轻度认知障碍开始由TIA、高血压和心脏病加速。白质疏松在认知衰退之前就已出现。TIA、高血压和高脂血症与血管性痴呆相关。皮质灌注过度下降、灰质和白质密度减低以及脑萎缩与认知衰退相关。
